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Chapter 2. The History of Crisis Intervention. TWO KEY FIGURES IN CRISIS INTERVENTION. Eric Lindemann Gerald Caplan Created the Wellesley Project as a result of the Coconut Grove fire in Boston, 1942 Preventive psychiatry emphasized early intervention to minimize psychological impairment.
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Chapter 2 The History ofCrisis Intervention
TWO KEY FIGURES INCRISIS INTERVENTION • Eric Lindemann • Gerald Caplan • Created the Wellesley Project as a result of the Coconut Grove fire in Boston, 1942 • Preventive psychiatry emphasized early intervention to minimize psychological impairment
1950’s through the 1960’s • Introduction of psychotropic medications such as thorazine and lithium began the process of the deinstitutionalization of the state hospital mentally ill patients. • Short-Doyle Act funded community mental health centers throughout the country
1960’s through 1970’s • Suicide prevention • Journals and scientific research about crisis intervention and suicide • Grass roots movements lead to the creation of non-profit agencies and use of paraprofessionals • Colleges created counseling programs
1980’s through the 1990’s • Managed care • Brief therapy was more cost effective • Emphasis on crisis intervention, all mental health workers would provide case management and short term care
21st Century • Bills still pending in congress about the rights of the mentally ill. • Funding at federal level is minimal • California trend is to create new programs for mental health care (Proposition 63 has passed) this creates thousands of jobs and facilities for mentally ill • Crisis intervention still the preferred mode by all funding sources.
Timeline in the Development ofCrisis Intervention (Continued)
Contributions fromother Modalities Psychoanalytic Approach: • Psychic energy is finite and limited. We can only handle so much stress and then something gives for a period of time until coping skills are learned or defense mechanisms are utilized. • An individual’s past experiences will determine how current experiences are dealt with and how a crisis will be resolved. Existential Approach: • Humans are responsible for decisions and capable of self-awareness and choice. • Anxiety is a normal part of the human condition and impetus for growth.
Contributions fromother Modalities Humanistic Approach: • Humans are capable of self-directed growth and there is hope and optimism about life struggles being manageable. • A genuine relationship with a counselor where empathy is shown is vital to therapeutic change. Cognitive Approach: • Human emotions and behavior is related to cognitions and perceptions about our experiences. • Helping an individual to alter cognitions when in a crisis state is therapeutic.
Contributions fromother Modalities Behavioral Approach: • Brief, goal oriented counseling which is directed at changing behaviors which are maladaptive to normal functioning. Family Systems Approach: • Runaways in a family is analogous to a crisis in an individual in that normal counteractive mechanisms don’t work to return to homeostasis. • Solution oriented therapy aimed at helping families adjust to transitions in family member’s development cycle.
BRIEF THERAPY Not the same as crisis intervention • Clients explore past patterns of behavior and how these prevent successful lifestyles and choices. • More explorative rather than structured • Time limited, but not focused solely on the crisis
THE ABC MODEL OF CRISIS INTERVENTION • A: Developing strong rapport • B: Identifying the nature of the crisis and altering perceptions • C: Offering coping skills